Healthcare Provider Details

I. General information

NPI: 1982539151
Provider Name (Legal Business Name): DALIA ESMERALDA KOO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DALIA ESMERALDA LIMON GOMEZ

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 HARTREY AVE
EVANSTON IL
60202-1056
US

IV. Provider business mailing address

849 WALTER AVE
DES PLAINES IL
60016-3230
US

V. Phone/Fax

Practice location:
  • Phone: 847-666-3494
  • Fax:
Mailing address:
  • Phone: 224-214-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209035327
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: